Patient Benefits Representative Sr. Float

The US Oncology Network•Dallas, TX

2h•Onsite

About The Position

The Patient Benefits Representative works under general supervision in the Revenue Cycle Department at Texas Oncology, supporting two oncology locations. The role educates patients about insurance coverage and benefits, assesses their ability to meet financial obligations, and may provide information about assistance programs. It also updates and maintains patient insurance eligibility, coverage, and benefits in the system. The position supports and adheres to the US Oncology Compliance Program, including its Code of Ethics, Business Standards, and Shared Values. This is a full-time position at the 8196 Walnut Hill #100 clinic in Dallas, Texas. The typical work week is Monday through Friday, between 7:30 a.m. and 5:00 p.m. The position may be filled at Level 1 or Senior level depending on the candidate’s relevant experience.

Requirements

High school diploma or equivalent required for Level 1.
At least three years of patient pre-services coordinator or equivalent experience required for Level 1.
Proficiency with computer systems and Microsoft Office, including Word and Excel, required.
Knowledge of CPT coding and HCPS coding application required.
Ability to communicate clearly verbally and use appropriate and correct terminology required.
Successfully complete required e-learning courses within 90 days of occupying the position.
For Senior level, at least three years of pre-services coordinator experience and two years of patient benefits experience are required.
For Senior level, demonstrate knowledge and appropriate application of insurance coverage benefits and terminology.
Ability to meet the position’s physical demands, including sitting or standing, talking or hearing, handling and lifting patients, manual and finger dexterity, eye-hand coordination, extensive standing and walking, and occasional lifting and carrying of items up to 40 pounds.
Corrected vision and hearing to the normal range are required.

Nice To Haves

For Senior level, an associate degree in Finance or Business, or four years of revenue cycle experience, is preferred.

Responsibilities

Obtain insurance coverage information and patient demographics before treatment, and explain coverage, benefits, co-pays, deductibles, and out-of-pocket expenses.
Assess patients’ ability to meet expenses and discuss payment arrangements.
Educate patients about financial assistance programs when applicable, identify sources of assistance, and help patients complete forms.
Complete Patient Cost Estimate forms based on diagnosis, estimated insurance coverage, and financial assistance.
Complete appropriate reimbursement and liability forms for patient review and signature, and forward appropriate information and forms to the billing office.
Obtain insurance pre-authorization or referral approval codes from the Clinical Reviewer before each treatment.
Review patient account balances and notify the front desk of patients who should meet with staff.
Ensure patient co-pay amounts are entered correctly in the system or conveyed so the front desk can collect them appropriately.
Verify and update patient demographics and insurance coverage in the computer system at each visit according to Standard Operating Procedures.
Stay current on available financial aid, build professional relationships with financial aid providers, and network with them to find leads to other assistance programs.
Follow confidentiality requirements and state, federal, and HIPAA laws and guidelines concerning patient records.
Maintain updated manuals, logs, forms, and documentation.
Complete additional duties as requested or assigned.